Esophageal Adenocarcinoma in Populations with Gastroesophageal Reflux Disease

Incidence of EAC in patients with GERD was very low overall, especially among men younger than 50 and women at any age.

The incidence of esophageal adenocarcinoma (EAC) has increased rapidly during the past few decades. National society guidelines recommend endoscopic screening for Barrett esophagus in patients with long-standing gastroesophageal reflux disease (GERD). However, the incidence for EAC in demographic subpopulations with GERD is unknown.


To estimate the age- and gender-specific incidences of EAC among non-Hispanic whites with GERD in the U.S., researchers created a Markov computer model using readily available national surveillance data. To place the results in context, they cited incidences of breast cancer and colorectal cancer (CRC), for which screening recommendations are well established.

Incidence was lower for women than for men. At any age, women with weekly GERD symptoms had a lower risk for EAC than men without GERD symptoms. For a woman aged 60 with weekly GERD, incidence of EAC was 3.9/100,000 person-years (similar to the incidence of breast cancer in men) compared with 34.6/100,000 for a man with weekly GERD. The incidence of EAC in men younger than 50 with weekly GERD symptoms was relatively low compared with those older than 60. For example, incidence of EAC was 1.0/100,000 person-years at 35 (6.7 times lower than the incidence of CRC) versus 60.8/100,000 at 70 (3 times lower than the incidence of CRC).


Citation(s):

Rubenstein JH et al. Esophageal adenocarcinoma incidence in individuals with gastroesophageal reflux: Synthesis and estimates from population studies. Am J Gastroenterol 2011 Feb; 106:254.

Shaheen NJ. Should women with heartburn undergo screening upper endoscopy for prevention of cancer? Am J Gastroenterol 2011 Feb; 106:261.